“Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” – Dr. Martin Luther King Jr.
as the nation honors Dr. Martin Luther King Jr.’s social justice work, it is important to recognize the country as a whole has benefited greatly from a movement towards equality for all, regardless of race, ethnicity, gender or affluence. But there is still work to be done, especially on the issue of health.
In Missouri, racial and ethnic minorities frequently have lower incomes, higher rates of poverty, and less insurance coverage, contributing to higher incidence of chronic disease and death at an earlier age. African Americans in Missouri lag behind whites on many health indicators, such as the incidence of obesity, asthma and diabetes.
One approach to reducing these disparities is increasing the availability of affordable health insurance to individuals and families who are under-insured or uninsured.
The passage of the Affordable Care Act (ACA) is a significant (and necessary) step toward getting more people insured. For the first time, all Americans can buy health insurance that is not biased by health status and makes assistance available for those who could not otherwise afford insurance.
Until this law passed, there was no incentive for insurance companies to sell their products to low-income families and individuals. The ACA changes the rules: everyone can have access to health insurance and no-one can be asked about their health conditions.
Our state is one step closer to providing opportunities for all Missourians to have greater control over their health care through more insurance choices through the Missouri Health Insurance Marketplace. All Missourians have the opportunity to purchase insurance with access to navigators, at no cost, to help make sense of health insurance options.
To date, more than 33,000 individuals have newly received access to quality health care coverage through the Marketplace. Unfortunately, some Missourians will continue to be uninsured since they are not eligible for financial help and do not qualify for Medicaid under current rules.
The ACA has broken down some of the barriers contributing to health inequalities, but there is still work to be done in Missouri.
There is an opportunity for the state to expand Medicaid and fill in the coverage gaps left behind. There are about 200,000 adults, who currently make too much money to qualify for Medicaid, but too little to receive financial assistance.
There are many steps that can be taken to improve Missourians ability to make good health decisions, including using more plain language when talking about health care and helping newly insured Missourians understand how health insurance works.
By creating economic opportunities and decreasing income disparities, we can address health disparities. People with lower socioeconomic status have a higher likelihood of having a major illness and dying younger.
How do we make access to quality affordable health care equitable and not a function of zip-code or income or race? How do we reconcile that Americans pay more for health care than any other nation but do not have the most desirable health outcomes in the world?
The ACA addresses some of the more persistent health differentials in our country, but these disparities have taken generations to make – let’s not take generations to abolish them.
Monday, January 20 presents an opportunity to honor the hard-won progress for which Martin Luther King Jr. and a generation of men and women fought. It also provides a chance to commit to the work before us. Health and health care cannot be left to the lottery of how much we earn, who our parents are, and where we live. The ACA is already having a positive impact on the health of many Missourians but it is time to improve the health of all.
Ryan Barker is vice president of health policy, Missouri Foundation for Health.
